Xu Meiping, Peng Yiyi, Zheng Fuhao, Yu Huanyun, Zhou Jiawei, Zheng Jingwei, Wang Yuwen, Hou Fang, Yu Xinping
Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China.
National Clinical Research Center for Ocular Diseases, Wenzhou 325027, China.
J Clin Med. 2023 Feb 6;12(4):1283. doi: 10.3390/jcm12041283.
To assess the clinical effectiveness of orthoptic therapy in the postoperative stabilisation and rehabilitation of binocular function in children with intermittent exotropia (IXT) after surgery.
This was a prospective, parallel, randomised controlled trial. A total of 136 IXT patients (aged from 7 to 17 years) who had been successfully corrected at 1 month after surgery were enrolled in this study, and 117 patients (58 controls) completed the 12-month follow-up visit. The primary outcome was established as the proportion of patients with suboptimal surgical outcomes, which were defined as: (1) exodeviation ≥10 prism diopters (PD) at distance or near using the simultaneous prism and cover test (SPCT), or (2) constant esotropia ≥6 PD at distance or near using SPCT, or (3) loss of 2 or more octaves of stereopsis from baseline. The secondary outcomes were the exodeviation at distance and near using the prism and alternate cover test (PACT), stereopsis, fusional exotropia control and convergence amplitude.
The cumulative probability of suboptimal surgical outcome by 12 months was 20.5% (14/68) in the orthoptic therapy group and 42.6% (29/68) in the control group. There was a significant difference between these two groups (χ = 7.402, = 0.007). Improvements in stereopsis, fusional exotropia control and fusional convergence amplitude were found in the orthoptic therapy group. A smaller exodrift was found in the orthoptic therapy group at near fixation (t = 2.26, = 0.025).
Early postoperative orthoptic therapy can effectively improve the surgical outcome as well as stereopsis and fusional amplitude.
评估正位视疗法对间歇性外斜视（IXT）患儿术后双眼功能稳定及康复的临床疗效。
这是一项前瞻性、平行、随机对照试验。本研究共纳入136例术后1个月成功矫正的IXT患者（年龄7至17岁），117例患者（58例对照）完成了12个月的随访。主要结局指标为手术效果欠佳患者的比例，其定义为：（1）使用同时三棱镜遮盖试验（SPCT）时，远距离或近距离外斜视度≥10棱镜度（PD）；（2）使用SPCT时，远距离或近距离恒定性内斜视度≥6 PD；（3）立体视较基线损失2个或更多倍频程。次要结局指标为使用棱镜交替遮盖试验（PACT）测量的远距离和近距离外斜视度、立体视、融合性外斜视控制及集合幅度。
正位视疗法组12个月时手术效果欠佳的累积概率为20.5%（14/68），对照组为42.6%（29/68）。两组之间存在显著差异（χ = 7.402，P = 0.007）。正位视疗法组的立体视、融合性外斜视控制及融合性集合幅度有所改善。正位视疗法组在近注视时发现较小的外隐斜（t = 2.26，P = 0.025）。
术后早期正位视疗法可有效改善手术效果以及立体视和融合幅度。
